PS 02-62 WHICH MEASUREMENT OF BLOOD PRESSURE IS MORE ASSOCIATED WITH EJECTION FRACTION PRESERVED HEART FAILURE WITHOUT HYPERTENSION: CENTRAL BLOOD PRESSURE OR PERIPHERAL BLOOD PRESSURE?

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Abstract

Objective:

Peripheral systolic blood pressure (pSBP) has been used to predict ejection fraction preserved heart failure (HFpEF). However, the assessment of superiority between pSBP and central SBP (SBP2) to predict ASCVD in patients without hypertension (HTN) has not been fully established.

Design and Method:

Two hundred and twenty patients (male:female ratio 115:105, mean age 54.2 ± 14.7 years) without HTN were enrolled from subjects who simultaneously received transthoracic echocardiography and non-invasively semiautomated radial artery applanation tonometry (using an Omron HEM-9000AI) in the Department of Internal Medicine, St. Vincent's Hospital, from July 2011 to May 2015. Moreover, the area under the receiver operating characteristic curve (AUC) of SBP2 was compared with that of SBP to identify HFpEF.

Results

: Thirty nine subjects (male:female ratio 20:19, mean age 65.9 ± 11.3 years) were diagnosed as HFpEF according to ESC guidelines for diagnosis and treatment of heart failure 2012. HFpEF patients had significantly higher pSBP (131 ± 20 mmHg vs 126 ± 14 mmHg), SBP2 (125 ± 21 mmHg vs 116 ± 16 mmHg) and pulse pressure (54 ± 19mmHg vs 49 ± 11mmHg) than the patients without HFpEF. After multivariate analysis after adjusted for age, gender, body mass index, fasting plasma glucose, diabetes, lipid profiles, antihypertensive medication and lipid-lowering medication, SBP2 (β = 0.231, 95% CI 1.036 to 1.289, p = 0.010) or pSBP (β=0.887, 95% CI 0.800 to 0.982, p = 0.021) were associated with HFpEF.. In addition, AUC (0.639) of pSBP was significantly greater than that of SBP2 to identify HFpEF. (P = 0.007).

Conclusions:

Central blood pressure is superior to pSBP in identifying HFpEF, although both peripheral and central SBP are associated with HFpEF in patients without hypertension.

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